Management of Brachial Artery Pseudoaneurysms in Intravenous Drug Abusers

Rehman, Khalil Ur; Berlas, Muhammad Fahad; Din, Najam Ud; Ali, Ghulam; Salahuddin, Farhina; Mumtaz, Asad

doi:10.7759/cureus.12315

Cited by 5 publications

(7 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…So intravenous drug addicts resort to another easily accessible route which is femoral vein in the groin region, where they accidentally breech the wall of femoral artery leading to development of pseudoaneurysm 3 . Multiple injuries to the vessel -----------------------------------------------------------------------------------------Received on 05-02-2023 Accepted on 23-04-2023 wall due to repeated injections leads to collection of blood in the adjacent tissues with subsequent development of a pseudoaneurysm (false aneurysm), which is distinguished from true aneurysm by lack of all three basic layers of the wall of an artery 4 .…”

Section: Introductionmentioning

confidence: 99%

Embolectomy at the Time of Ligation of Femoral Vessels in Psuedoaneurysm in Intravenous Drug Addicts can save Limb

Rasool¹,

Butt²,

Arif³

2023

PJMHS

View full text Add to dashboard Cite

Aim: To determine the impact of embolectomy at the time of ligation of femoral artery in management of pseudoaneurysmin intravenous drug addicts Study design: Descriptive cross-sectional study Methods: This study was carried out at Vascular surgery department, CMH Lahore and included 28 patientsof intravenous drug addiction of both genders presenting in emergency of CMH Lahore with viable limb from 1st August 2021 to31st January 2023. Unsalvageable limbs at the time of presentation were excluded from the study. SPSS Version 20.0 was used for data analysis of age, sex, co-morbidities (infection), mode of presentation and outcome variables. Results: This study comprised of28 patientsadmitted through Emergency Department of CMH, Lahore. The mean age was found to be 32.16 years ±7.63 years. All patients 28(100%) were males with majority belonging to third decade of life 20(71.4%).Chronic viral infection was present in all cases. Almost half of them had hepatitis B virus infection (48%) while cases positive with hepatitis C virus and HIV infections were 37% and 15% respectively.Majority of the patients came to the hospital with bleeding from ruptured pseudoaneurysm (60.7%) and infected pulsatile swelling (32.1%), while pulsatile swelling without bleedingand wrong diagnosis were least common.Alllimbs were salvaged in first and second follow-up visits, 20 patients were lost on follow up on 12th week. Conclusion/Practical implication: Embolectomy is a very useful adjunct in the management of pseudoaneurysm of intravenous drug addicts. It should be routinely practiced in treatment of these patients to save limbs. Keywords: Embolectomy, ligation, femoral vessels, intravenous drug addicts

show abstract

Section: Introductionmentioning

confidence: 99%

Embolectomy at the Time of Ligation of Femoral Vessels in Psuedoaneurysm in Intravenous Drug Addicts can save Limb

Rasool¹,

Butt²,

Arif³

2023

PJMHS

View full text Add to dashboard Cite

show abstract

“…A false aneurysm (arterial aneurysm) differs from a true aneurysm as in it the patient lacks all 3 normal components of the arterial wall. It results due to recurrent trauma to the vessel wall which leads to hematoma formation in the surrounding tissues 5 .…”

Section: Introductionmentioning

confidence: 99%

Management of Brachial Artery Pseudoaneurysms in Intravenous Drug Abusers

Sadiq¹,

Nasir²,

Iftikhar³

et al. 2022

PJMHS

View full text Add to dashboard Cite

Aim: To assess the outcomes of ligation and excision of brachial artery pseudoaneurysm without revascularization in IV drugs users. Place & duration of study: From Jan 2021 to Jan 2022 at the department of Surgery of Doctors Hospital & Medical Centre Lahore. Methodology: A retrospective observational study was conducted at the surgery department of Doctors Hospital & Medical Centre Lahore for 1 year. Intravenous drug abusers, aged between 18-65 years diagnosed with brachial artery pseudoaneurysm were included in the study whereas pseudoaneurysm was caused due to arteriovenous fistula, hemodialysis, and trauma or in patients who had undergone revascularization were excluded from the study. The data were processed using SPSS 20.0. Results: A total of 15 intravenous drug users were enrolled in the study. The mean age of the participants was 33.4±5.4 years, and the mean period of addiction was 1.9±2.5 years. Majority of patients (65%) presented with an affected right arm. The most common presentations were: bleeding pseudoaneurysm (73.3%), oozing pulsatile mass (20%), and infected pulsatile mass (6.6%). Following the intervention, limb salvage was achieved in all patients. Ischemia was reported in none of the patients. Conclusion: The excision and ligation of the pseudoaneurysm can be an effective treatment option for the pseudoaneurysm of a brachial artery caused due to drug addiction. Keywords: The brachial artery, pseudoaneurysm, intravenous drug users, drug addiction

show abstract

“…A PSA differs from a true aneurysm by the absence of all 3 vessel walls or by the waveform on duplex Doppler ultrasound. [1,3,4] A PSA induced by a medical procedure is known as an iatrogenic pseudoaneurysm (IPA). PSA therapy is essential due to the possibility of rupture and bleeding.…”

Section: Introductionmentioning

confidence: 99%

“…A pseudoaneurysm (PSA) is generated when the vascular wall is injured, resulting in a communicating hematoma in the surrounding tissue. [ 1 , 2 ] Blood flows into and out of the mass when the systolic and diastolic stages shift, causing it to appear as a pulsatile mass and the blood signal to be investigated by ultrasonography. A PSA differs from a true aneurysm by the absence of all 3 vessel walls or by the waveform on duplex Doppler ultrasound.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Single ultrasound-guided local high-dose thrombin injection in the treatment of giant brachial artery pseudoaneurysm: A case report

Xiu

Yuan

et al. 2022

Medicine

View full text Add to dashboard Cite

Rationale: Pseudoaneurysm (PSA) is a common complication related to vascular intervention, and surgical therapy is the primary method. However, a giant brachial artery PSA over 2 weeks is rarely observed. Due to the adhesion of surrounding tissue, thrombus organization, the extensive injury, and the high expense of transluminal stent-graft placement, a single ultrasoundguided local high-dose thrombin injection can be a therapy option. Such cases are rarely reported.Patient concerns: A 71-year-old man with a history of left elbow fossa interventional puncture presented to our hospital with a pulsatile mass in the left elbow fossa. He had a history of cerebral infarction 32 years prior without sequelae, emphysema for more than 2 years, hyperlipidemia for 3 months, and prostatic hyperplasia for 8 months. After conservative therapy, the lumbar compression fracture produced by trauma 24 years ago healed, and the intracranial hematoma induced by trauma ten years ago was absorbed.Diagnosis: Ultrasound examination showed giant mixed echoes on the posterior medial side of the left brachial artery. Interventions:The patient underwent a single ultrasound-guided local high-dose thrombin injection to treat giant brachial artery PSA.Outcomes: Following therapy, the ultrasonography revealed that extensive thrombosis immediately formed in the cavity, and the internal blood flow signals had completely vanished. A week later, a physical examination showed that the PSA had shrunk with no apparent tenderness and that the texture had hardened. Pulsation and vascular murmurs disappeared. Ultrasound showed that the PSA was reduced, and no blood flow signals were found.Lessons: A single ultrasound-guided local high-dose thrombin injection had a considerable effect in curing large iatrogenic PSA. However, when deciding on the best therapy, specificity must be taken into account.

show abstract

Management of Brachial Artery Pseudoaneurysms in Intravenous Drug Abusers

Cited by 5 publications

References 13 publications

Embolectomy at the Time of Ligation of Femoral Vessels in Psuedoaneurysm in Intravenous Drug Addicts can save Limb

Embolectomy at the Time of Ligation of Femoral Vessels in Psuedoaneurysm in Intravenous Drug Addicts can save Limb

Management of Brachial Artery Pseudoaneurysms in Intravenous Drug Abusers

Single ultrasound-guided local high-dose thrombin injection in the treatment of giant brachial artery pseudoaneurysm: A case report

Contact Info

Product

Resources

About